Insulin resistance experts help

What does homa ir mean and how do you get it, and insulin, measured?

Given that you have insulin resistance and you wish to lose weight, get yourself a copy of “A New Atkins For a New You” as the diet in it is very likely to work well for you. Keep to the “induction phase” 100% for a few weeks and I expect you will start to see results.

(20 hour fasts a day can help, but you carb intake may be too high in the meals you are eating in the 4 hours each day.)

Tagging @CherryAA, please could input on the matter of fasting insulin levels as I understand you have reduced yours?

Alison Campbell said:

Tagging @CherryAA, please could input on the matter of fasting insulin levels as I understand you have reduced yours?

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My goal is certainly to try to keep insulin low if I can . It is also true that since I started testing it came down from 20 to 8. I am also aware that is it quite volatile, and so could be a much higher number at an individual test depending on what had been eaten the previous day before fasting, and depending on your state of health overall.

The critical issue is how much is swirling around much of the time, unfortunately there are no continuous monitors to tell you that. The other issue is that the more circulating insulin you have the harder it will be to lose weight, because it is the fat making hormone.

As far as I understand it - eating ANY food causes an insulin response including fats and proteins. Thus one could get a high insulin response by eating a lot of fats and proteins even if this did not cause blood glucose to rise. This is why people like Dr Jason Fung recommend some fasting. It is also why a diet which consist of smaller meals of any time snacked all day long is likely to give rise to higher levels of insulin compared to eating with large gaps in-between even if the snacks are low carb. There are many people out there recommending that one should have 13 hours between dinner and breakfast for ALL of the population to try to give one's body the best chance of going back to low levels between meals.
I did take part in a study that showed that fasting insulin levels are correlated to time spent on the LCHF diet and come down gradually over a period of a few years This makes sense given how long it will have taken for insulin levels to rise in the first place.

In my own case the reduction from 20 to 8 came with - about 1300 calories a day, 60% fat, 20% carbs, 20% protein. Focused on saturated fats, above round vegetables, no seed oils. Actually my weight itself stayed stable throughout that insulin transition and I too have trouble getting to the next stage in weight loss.

My thinking would be - if I follow a real foods diet, LCHF, get into ketosis, eat meals infrequently, avoid industrial seed oil,s try to do some exercise ( walking and preferably a bit of HIT ) a few times a week, and try to get good sleep, then that is about the best I can do to try to minimise innumerable problems including diabetes without recourse to drugs. it seems to work for me. I can certainly tell via my monitor and my weight if i start to et more carbs - in my case around 40g per day seems to be the switch point/ -e under 20g = weight loss 20-40g equals weight maintenance , above 40g weight gain. I assume my resulting insulin follows as similar pattern !
Hope that helps .

@CherryAA is one of the few posters on the forum who has had more than one fasting insulin test and documented the fall as part of a study she took part in.

It is interesting to look at the make up of both of the diets detailed above. Although they are both low carb, the macros come out very differently. LCHF against possibly LCHP 6-8 meals a day.

It could be much more complex as you say but I saw a connection between two members of the forum that I felt was worth exploring.

@Flair have you had your thyroid function tested recently?
Lchf didn't work for me but low carb does. Don't add cheese, nuts, cream and other saturated fats in excess.too much fat counteracted things for me.
I've had a few of these things recently due to being christmas but I stop losing weight.
I lost weight which reduced my IR on low carb, low fat. Only then did my body start using body fat instead of dietery fat. However I have underactive thyroid and pcos so hormones are messed up.

No2D said:

Yes, CherryAA and the things she's done are awesome. I have to check myself because I've had good success with LC for my FBG and weight loss. I'm prone to the one size fits all. But I realize that's only true of my old pants.

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Thanks for the compliment I have nowhere near resolved my own situation and for some reason I am finding it increasingly hard to stick to my diet in terms of not overeating - though thankfully at present that has been limited to more proteins rather than actually wanting to eat sugar.

Eating to your meter
It is true that eating to the meter will definitely keep down glucose and that is measurable. However other research even amongst non diabetic people shows that the amount of insulin response we get to individual foods varies enormously by individual, so whilst eating to the meter may help, it may not be enough if insulin levels are really volatile depending on food intake. ( hence the popularity of fasting as a means of overcoming weight stalls)


In terms of PCOS - then I've seen a fair bit of literature that suggests that sticking to an LCHF diet is still a good way to go in terms of ameliorating the symptoms.

In terms of actual numbers the OP started off with - the current "normal " range for fasting insulin is 2- 25 iUi/ml so actually ALL of your figures are in the normal range. It is true though that normal is not optimal so lower is better.

Composition of cholesterol

Can I suggest to the OP that they also take a look at the composition of their cholesterol. If HDL is low and Triglycerides are high, then regardless of glucose or Hba1C results, that is an indication that there are too many carbohydrates in the diet. Studies show that the ratio can be improved by less carbs and more saturated fats. - that is what happened to me.

Time of Eating
One thing I can say with certainty is that for me, my blood sugar profile is completely different and MUCH worse, if I snack compared to eating just two meals a day even with the same calories and foods. I think I still have a propensity to create far too much insulin in response to food in general not just carbs but also proteins and that may be why its so hard to lose weight I seem to have got to the stage where my mind knows I am not going to give in on the sugar, so its driving me to put in more proteins instead. Thus I KNOW that for me little and often, lots of protein, drives up my responses compared to more fats and less frequently.

I also know that it is not enough to simply eat LCHF to lose weight. Instead it has to be LCHF with calorific restriction . I have effectively stayed the same wight (89kg) for a year now using LCHF and various types of experimentation. I can lose a few kilos but my body then returns me back to 89kg - which seems extraordinary but its true. Sometimes I get rather depressed about it, but then I think.I have never before managed to lose weight ( 26kg) AND the KEEP it off for a long period afterwards. I have never managed to keep in control of what I eat in terms of quality before. I have therefore decided that sticking with natural foods eaten infrequently is the lifestyle that makes most sense for me and is most likely to keep me as healthy as possible. When I then feel able to give myself a new "Push" - ( classic 1 January LOL then I will )

Insulin Resistance
I continue to research the "insulinaemia" theory - .i.e its too much insulin that underlies a huge proportion of diseases, and that is refined carbs coupled with industrial seed oils that does it. Every day something new comes up that continues to add weight to that theory, I post the details to that on my blog - Unifying theory.

As part of that I have now appreciated how significant vitamin D and K are to the overall process and I am deliberately trying to correct that with supplements of both. My knowledge of how important Vitamin D is to the human body then led me to look up Acanthosis Nigricans (AN) and Vitamin D and sure enough I found this.

https://www.ncbi.nlm.nih.gov/pubmed/25010776
This basically says ( I think- though its very muddled) that the severity of AN is correlated to the extent of vitamin D deficiency and that that is a stronger correlation than AN and Homa IR. Thus if you have your vitamin D levels checked you may find that you are severely deficient there. If so then this may be corrected by vitamin D ( plus K2) supplements . I treated myself to a Vitamin D sunlamp for xmas to try to improve this further. ( nearly all of those with diabetes have vitamin D deficiency)


Seed Oils
There continues to be a lot of backlash into LCHF amongst the research community , in particular Keto coming under fire. One thing that strikes me about much of the research is that because of the fear of saturated fats, many of these keto experiments include limiting sat fats and thus increasing PUFA om 6 oils. As that is in my view a prime cause of insulin resistance - I think that may also be why there is such a division of opinion about the benefits of the LCHF way of life and its effects on health.

I am therefore very firmly of the opinion that for me - cutting out all vegetable seed oils and not fearing butter and the fats from natural food is the way to go whilst eating real foods not very often.

I have also looked into other types of insulin resistance and posted here about Type B Insulin resistance . I provide the details again below because it includes acanthosis nigricans as an indicator . so it may be that the OP can consider if they fit any of the criteria in that study.


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2913034/
Background: Type B insulin resistance belongs to a class of diseases caused by an autoantibody to a cell surface receptor. Blockade of insulin action results in hyperglycemia, hypercatabolism, severe acanthosis nigricans, and hyperandrogenism in women. This rare autoimmune disorder has been treated with various forms of immunosuppression with mixed success.

Methods: We describe 14 patients with type B insulin resistance referred to the National Institutes of Health, adding to an existing cohort of 24 patients. This report focuses on seven patients who were treated with an intensive combination protocol of rituximab, cyclophosphamide, and pulse corticosteroids aimed at control of pathogenic autoantibody production. Hematological, metabolic, and endocrine parameters, including fasting glucose, glycated hemoglobin, insulin dose, lipids, and testosterone, were monitored before and after treatment.

Results: All seven treated patients achieved remission, defined as amelioration of hyperglycemia, discontinuation of insulin therapy, and resolution of hyperandrogenism. Glycated hemoglobin has normalized in all seven treated patients. Remission was achieved on average in 8 months from initiation of treatment. The medication regimen was well tolerated, with no serious adverse events.

Conclusions: In seven patients with type B insulin resistance, standardized treatment with rituximab, cyclophosphamide, and pulse steroids results in remission of the disease. Future studies will determine whether this treatment protocol can be applied to other autoantibody/cell surface receptor disease states.

In summary if it were me in your position I would - check my HDL and trig figures to see if current food intakes were giving me optimal lipids. Continue with intermittent fasting but make the foods low carb and low vegetable oils as well
Check my vitamin D levels and supplement as necessary. ( with D3 and K2 - it only works in the presence of K2) If all of the above figures are already optimal, then I would think about getting some more specialist help from an endocrinologist.

good luck !

Hi All,

Just a quick comment to say that insulin resistance is fundamental to understanding T2 and that Low Carbing and intermittent fasting are often brilliant at dealing with both.

However, there are those of us (I count myself in this) where our metabolisms are sufficiently ‘deranged’ through hormonal stuff like thyroid, pcos, and adrenal issues, that LC and IF do not have the desired effect - especially if that effect is weight loss.

Voice of experience here.

I respond well to LC and IF in terms of blood glucose levels, but like @Flair they simply do not help me lose weight. Nor does low calorie since by body just downgears it’s metabolic rate to match the lower calorie intake. And somehow I am reluctant to fast for weeks only to regain the weight afterwards as soon as I go back to my very low carb eating.

There is simply no ‘one size suits all’.

I would encourage Flair to prioritise Low Carbing and Low insulin over weight loss, as a long term health choice.

Brunneria said:

Hi All,

Just a quick comment to say that insulin resistance is fundamental to understanding T2 and that Low Carbing and intermittent fasting are often brilliant at dealing with both.

However, there are those of us (I count myself in this) where our metabolisms are sufficiently ‘deranged’ through hormonal stuff like thyroid, pcos, and adrenal issues, that LC and IF do not have the desired effect - especially if that effect is weight loss.

Voice of experience here.

I respond well to LC and IF in terms of blood glucose levels, but like @Flair they simply do not help me lose weight. Nor does low calorie since by body just downgears it’s metabolic rate to match the lower calorie intake. And somehow I am reluctant to fast for weeks only to regain the weight afterwards as soon as I go back to my very low carb eating.

There is simply no ‘one size suits all’.

I would encourage Flair to prioritise Low Carbing and Low insulin over weight loss, as a long term health choice.

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I agree with that point of view. In practice if one is eating a good diet and as a result has low glucose, high HDL low triglycerides, adequate vitamin d and a good balance of omega 3 to omega 6 oils, then that probably puts you into the healthiest category of people regardless of what you actually weigh. When one then couples that with the fact that all cause mortality is actually lower at higher BMI ( 25- 30) than under 25 the the whole focus on being slim becomes a little irrelevant. It is being obese with deranged metabolism and poor health markers that is dangerous, but then so is being slim with the same deranged metabolism and poor health markers.

If its any help I'm very impatient but this summer I decided to just keep at it, longterm. It helped me lose weight.
I think its also how long it takes to work differs person to person too.
I wish I was more patient.
As soon as I tasted those halloween treats my weight loss stopped.
Hoping to mimic summers diet and movement for more weight loss. We'll see.

However ultimately a healthy diabetic can be any weight!

To keep it simple IR is a determined by its cause.
Pcos, diabetes, dementia and many other conditions are being looked back on and discovering the common denominator.
Just like leptin resistance is being investigated too.

So far I've found that to improve IR I have to lose weight. Primary. That's because I'm just short of morbibly obese. Bmi 44.

I've found I need to find ANY way to lose weight, which will help with my IR.
However not everyone has my severe IR.
Thin diabetics are proving to be increasing their IR and having diabetes detected early on, unlike mine 40+yrs of it.
Even prediabetes is an indication of IR, in some.

When I'm losing weight easily I'm doing so because I'm reducing my insulin resistance.
For me low carbing and low fat is my ideal diet....for me. End of.

So....I found my perfect diet now, I've found a way to lose weight and surgery to help me ferment it...hopefully for life.
I can measure my IR by how many insulin units I need. So of course I have high insulin resistance. Nearly 300units of mixed insulin proves that. Goodness knows how much of my own insulin is getting used on top.
Insulin resistance has interferred with my hormones and fat building metabolism. Diabetes is just a small part of that.
Recently I had my heart checked and luckily it is good but it is well known to cause heart issues too. Excessive glucose and in and our of vessels causing hardening of arteries is just one more small part of diabetes but excessive insulin is questioned for inflammation.
I must note I don't have the inflammation my whole family does and of which I'm truely thankful.
I must have diabetes instead of inflammation however some diabetics have both but not my heavy IR?
Awaiting bariatric surgery most have immobility due to obesity but not due to diabetes or maybe even IR.
My immobility is due to bulging discs, scatica and a numb foot/toe which is questioned as of scatica or diabetes. Only one god knows.
IR however I can see when I click my insulin pens.

Flair said:

Yes I do have a little low thyroid wich is controled with euthyrox. But the symptoms are not connected to this says my doctor it controlled.

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Mine too, well controlled but IR might be the cause of some peoples lazy t4 to t3 conversion or tsh levels.
Just keep it in mind if your thyroid status starts improving.

Flair said:

You assume so you don t know if your insuline is okay?,and what can you see in your meter connected to carbs.

When I did 1 year of low carb was in 2015 2016 I did not have An. I did not no why I did feel not good and did not loose weight.
I also did have gestionel diabetis and could not loose the baby weight.

The diet you do is different from the mine. I did 10%carbs 40%fat 50 % protein.
I also did change from 1200 calorie to 800. And try more fat less protein.

But almost no result. When I gave it all up went back to normal food. Then I Got acanthosis nigracans.

And my sleep disorder started in the low carb diet with a lot of pvc. Which I made me think this is maybe not good for me.

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For me personally I can tell from my meter when I eat both carbs and proteins, though clearly the protein figures take longer to show through and show less spikes. instead I end up with a higher general level of blood sugar overall. jason Fungs

If you look at the facebook groups for OMAD (one meal a day) and Dr Jason Fung - intermittent Fasting, they both have lots of people trying to work through stalls in weight through changing the timing of when they eat. I do think that when the type of food is not helping you, then it might be that you have got used to tiny snacks instead. I used to try to eat 800 calories a day by having really tiny meals every time the hunger got too much ( eg two grapes, one tomato, 10 g nuts, tiny piece of cheese) from looking at my meter, I now think that insulin levels go down much better if you eat the same 800 calories in one meal instead. the reason for this is that insulin seems to respond to the fact of food at all, rather than the absolute amounts of it.

I have tested this on others and for example - one boiled sweet, which many of us might have eaten thinking " one can't hurt" is enough to spike a NON DIABETIC sugars and therefore insulin for two hours.

How overweight are you? how close is your waist to 50% of your height? have you got your cholesterol numbers ? each of these is helpful in seeing to what extent you need to lose visceral fat.